Former President Clinton and Bill Gates, co-chair of the Bill & Melinda Gates Foundation, on Monday called on world leaders to do more to combat the stigma surrounding HIV/AIDS, the New York Timesreports. At a joint panel discussion at the XVI International AIDS Conference in Toronto, Clinton said that "leaders don't necessarily have to be the reigning head of government if you have a critical mass" and that the "government does not undermine you with counterproductive policies." For example, Chinese officials initially "were in denial about AIDS and then they decided they wouldn't be and they turned on a dime," Clinton said (Altman, New York Times, 8/15). Gates said that when traveling to countries affected by HIV/AIDS, he frequently finds it difficult to talk with officials about behaviors that contribute to the spread of the HIV, such as unprotected sex and injection drug use. "I haven't come to a country where injecti[on] drug use is easily discussed or men having sex with men or commercial sex workers" is discussed, Gates said, adding, "I hope to go to that country some day, where none of those things are controversial or hard to discuss" (CP/CBC News, 8/14). Gates also said that stigma in part prevents developing countries from providing antiretroviral treatment to many HIV-positive pregnant women (New York Times, 8/15). Clinton added that the fear of being stigmatized and limited access to antiretroviral drugs prevents people in some countries from getting tested for HIV, which in turn undermines efforts to fight the disease. "I don't see how we're ever going to catch up, unless people are at least aware that they could be giving the virus to other people," Clinton said, adding that 90% of HIV-positive people in developing countries are unaware of their HIV status (CP/CBC News, 8/14).

Weak Infrastructure, Poverty Weak health care infrastructures in many countries also present one of the biggest obstacles to tackling HIV/AIDS, Clinton and Gates said, urging greater investment in health care workers and facilities. "The capacity to treat isn't so much gated by drug prices now as by personnel," Gates said (Chase, Wall Street Journal, 8/15). Clinton also said that the shortage of nurses in developing countries poses one of the largest barriers to increasing access to HIV/AIDS treatment and prevention programs. He added that trained health care workers are crucial to deliver care. Gates said that without enough skilled nurses, physicians and local health workers, HIV/AIDS would continue to spread unabated (Picard, Globe and Mail, 8/15). Clinton also urged HIV/AIDS advocates not to "patronize the poor." He added that impoverished populations "will live if you give them the tools to live."

PEPFAR Also during the session, Clinton and Gates praised the President's Emergency Plan for AIDS Relief for its role in providing treatment to people living with HIV/AIDS worldwide (Blandy, SAPA/Mail and Guardian, 8/15). "PEPFAR, on balance, has done a terrific amount of good," Clinton said. Gates said that PEPFAR is a "great success" on the "treatment front," adding that the program is "incredible in its impact. Lives are being saved, and this thing is being run very well" (New York Times, 8/15). In terms of PEPFAR's policy regarding the role of abstinence in HIV prevention, Clinton said, "An abstinence-only program is going to fail. On the other hand, if you want the benefit of American money and research, it is a mistake to walk away from the message altogether" (SAPA/Mail and Guardian, 8/15). Clinton and Gates also discussed the need to increase research on microbicides, the effect of poverty on HIV transmission and access to antiretrovirals (Black, Toronto Star, 8/15).

CBC TV: The segment includes comments from Clinton; Gates; Helene Gayle, co-chair of the AIDS conference and president of CARE; and Rafik-Pierre Sekaly, a researcher from the University of Montreal (Taylor, CBC TV, 8/14). The complete segment is available online in RealPlayer.

Citytv's "CityNews": The segment includes comments from Clinton, Gates and delegates at the conference (Reyes/Mulligan, "CityNews," Citytv, 8/14). Video of the segment is available online.

CTV's "CTV Toronto": The segment includes comments from Clinton and Gates (Delaney, "CTV Toronto," CTV, 8/14). Video of the segment is available online.

CTV's "Newsnet": The segment includes comments from Clinton and Gates (Sommer, "Newsnet," CTV, 8/14). Video of the segment is available online.

Kaisernetwork.org is serving as the official webcaster of the conference. View the guide to coverage and all webcasts, interviews and a daily video round up of conference highlights at www.kaisernetwork.org/aids2006. A webcast of the session with Gates and Clinton is available online.

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